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Efficacy of myringoplasty before 6 years of age: A STROBE analysis
H Khidichian1, F Simon1, N Leboulanger1
1Université Paris Cité, 75006 Paris, France; Paediatric Otolaryngology Department, Hôpital Necker-Enfants Malades, AP-HP, 75015 Paris, France.
Insights
Myringoplasty in children under 6 shows good results, with the underlay cartilage graft technique offering the best long-term success for tympanic membrane closure and hearing improvement.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Surgical Outcomes
Background:
- Tympanic membrane perforations are common in children.
- Myringoplasty aims to restore tympanic membrane integrity and hearing.
- Outcomes in very young children require specific evaluation.
Purpose of the Study:
- To assess anatomical and functional outcomes of myringoplasty in children under 6.
- To identify factors predicting surgical failure in this pediatric cohort.
- To compare different grafting techniques in young patients.
Main Methods:
- Retrospective analysis of 47 myringoplasties in children under 6 years.
- Evaluation of anatomical and audiological results at 6 weeks, 12 months, and 24 months.
- Analysis of predictive factors for myringoplasty failure.
Main Results:
- Overall success rate was 70% at 24 months.
- Underlay grafts (79% success) outperformed inlay grafts (25% success) (P=0.005).
- Significant improvement in audiometric thresholds (air-bone gap ≤20dB in 96% at 12 months).
Conclusions:
- Myringoplasty in children under 6 yields satisfactory anatomical and functional results.
- The underlay cartilage graft technique is superior for long-term outcomes.
- Early myringoplasty outcomes are comparable to older pediatric populations.
Objective:
To report anatomical and functional results and predictive factors for failure of myringoplasty in children under 6 years of age.
Material And Methods:
Retrospective study of myringoplasty for tympanic membrane perforation in children under 6 years of age with at least 2 years' follow-up. Anatomic and audiological results were evaluated before surgery, at 6 weeks (short-term), 12 months (medium-term) and 24 months (long-term). Predictive factors for failure were analyzed.
Results:
Forty-seven myringoplasties were included, with a mean patient age of 4.7±0.4 years. Thirty-nine received underlay grafts and 8 received inlay grafts. The rate of success (tympanic closure, and no otitis media with effusion, myringitis of tympanic retraction) at 6 weeks was 77%, and 70% at 24 months: 79% for underlay and 25% for inlay techniques (P=0.005). Audiometric thresholds improved significantly, with 96% of patients with air-bone gap≤20dB at 12 months after surgery, compared to 57% before (P=0.002). No risk factors for failure were identified, except use of inlay.
Conclusion:
Myringoplasty performed before the age of 6 yielded satisfactory anatomic and functional results, comparable to other pediatric series across all age groups. The underlay cartilage graft technique provided the best long-term outcomes.
